{"created":"2023-05-15T16:50:03.775509+00:00","id":27770,"links":{},"metadata":{"_buckets":{"deposit":"83ac5d65-b3fc-460c-a027-d6bb7bc5fb84"},"_deposit":{"created_by":6,"id":"27770","owners":[6],"pid":{"revision_id":0,"type":"depid","value":"27770"},"status":"published"},"_oai":{"id":"oai:nagasaki-u.repo.nii.ac.jp:00027770","sets":["8:9"]},"author_link":["123480","123475","123481","123483","123477","123478","123476","123482","123479"],"item_2_biblio_info_6":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2022-11-02","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"44","bibliographicPageStart":"e31401","bibliographicVolumeNumber":"101","bibliographic_titles":[{"bibliographic_title":"Medicine"}]}]},"item_2_description_4":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"Rationale: Eosinophilic granulomatosis with polyangiitis (EGPA) is belongs to the antineutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis (AAV) subgroups. EGPA, unlike other subgroups of AAV, including microscopic polyangiitis (MPA) and granulomatosis with polyangiitis, has the unique feature that both ANCA and eosinophilic inflammation are involved in its pathogenesis. Although AAV often relapses, there are currently no reports of EGPA developing during other subgroups of AAV. Herein, we document a case of EGPA that developed during the clinical course of MPA.\nPatient concerns: A 61-year-old Japanese woman was diagnosed with MPA based on interstitial lung disease and myeloperoxidase-ANCA positivity. After starting immunosuppression therapy, including prednisolone and tacrolimus, she was expected to achieve clinical remission. Nonetheless, she occasionally experienced MPA relapse, which required an increased prednisolone dose, rituximab, intravenous cyclophosphamide, and plasma exchange. Three years after MPA onset, she developed renal amyloidosis; thus, subcutaneous tocilizumab was added to her regimen. Following clinical remission, the administration interval of her subcutaneous tocilizumab therapy was extended and immunosuppressants were discontinued. She then developed bronchial asthma and mild eosinophilia (eosinophilic count: ~1000/μL). Further, a year later, she underwent total hip replacement using a titanium implant. Subsequently, she developed abnormal sensation in both hands, numbness, and muscle weakness, as well as palpable purpura and massive eosinophilia (eosinophilic count: ~8500/μL).\nDiagnosis: We diagnosed the patient with EGPA based on 5 items (asthma, multiple mononeuropathies, sinus abnormality, and extravascular eosinophils) of the 1990 American College of Rheumatology classification criteria.\nInterventions: We administered 400 mg/kg intravenous immunoglobulin for 5 consecutive days, 300 mg mepolizumab subcutaneously every 4 weeks, and 40 mg/day prednisolone following pulsed methylprednisolone therapy (1000 mg/day for 3 consecutive days).\nOutcomes: After these treatments, the patient’s symptoms improved, and eosinophilic count and inflammatory markers declined.\nLessons: The present case suggests that EGPA can be induced by the development of eosinophilic inflammation in other subgroups of AAV.\nAbbreviations: AAV = ANCA-associated vasculitis, ANCA = antineutrophil cytoplasmic autoantibody, CCL = chemokine (C–C motif) ligands, CRP = C-reactive protein, EGPA = eosinophilic granulomatosis with polyangiitis, IL = interleukin, ILC2 = group 2 innate lymphoid cells, ILD = interstitial lung disease, MPA = microscopic polyangiitis, MPO = myeloperoxidase, mPSL = methylprednisolone, PSL = prednisolone, TAC = tacrolimus, TCZ = tocilizumab, Th2 = T helper 2.","subitem_description_type":"Abstract"}]},"item_2_description_63":{"attribute_name":"引用","attribute_value_mlt":[{"subitem_description":"Medicine, 101(44), art. no. e31401; 2022","subitem_description_type":"Other"}]},"item_2_publisher_33":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"Wolters Kluwer Health, Inc"}]},"item_2_relation_12":{"attribute_name":"DOI","attribute_value_mlt":[{"subitem_relation_type":"isIdenticalTo","subitem_relation_type_id":{"subitem_relation_type_id_text":"10.1097/MD.0000000000031401","subitem_relation_type_select":"DOI"}}]},"item_2_rights_13":{"attribute_name":"権利","attribute_value_mlt":[{"subitem_rights":"ⓒ 2022 the Author(s). Published by Wolters Kluwer Health, Inc. This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited."}]},"item_2_source_id_7":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"1536-5964","subitem_source_identifier_type":"ISSN"}]},"item_2_version_type_16":{"attribute_name":"著者版フラグ","attribute_value_mlt":[{"subitem_version_resource":"http://purl.org/coar/version/c_970fb48d4fbd8a85","subitem_version_type":"VoR"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"Ide, Hiroyuki"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"Shimizu, Toshimasa"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"Koike, Yuta"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"Abe, Kuniko"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"Shigematsu, Kazuto"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"Nishihata, Shinya"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"Kojima, Kanako"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"Ichinose, Kunihiro"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"Kawakami, Atsushi"}],"nameIdentifiers":[{}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2022-11-24"}],"displaytype":"detail","filename":"M101_e31401.pdf","filesize":[{"value":"911.4 kB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"M101_e31401.pdf","url":"https://nagasaki-u.repo.nii.ac.jp/record/27770/files/M101_e31401.pdf"},"version_id":"07884f9c-26eb-4bdd-a659-e885b96b003c"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"Eosinophilic granulomatosis with polyangiitis","subitem_subject_scheme":"Other"},{"subitem_subject":"microscopic polyangiitis","subitem_subject_scheme":"Other"},{"subitem_subject":"myeloperoxidase-antineutrophil cytoplasmic autoantibody","subitem_subject_scheme":"Other"},{"subitem_subject":"titanium implant","subitem_subject_scheme":"Other"},{"subitem_subject":"tocilizumab","subitem_subject_scheme":"Other"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"eng"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"journal article","resourceuri":"http://purl.org/coar/resource_type/c_6501"}]},"item_title":"Development of eosinophilic granulomatosis with polyangiitis during the clinical course of microscopic polyangiitis: A case report","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"Development of eosinophilic granulomatosis with polyangiitis during the clinical course of microscopic polyangiitis: A case report"}]},"item_type_id":"2","owner":"6","path":["9"],"pubdate":{"attribute_name":"公開日","attribute_value":"2022-11-24"},"publish_date":"2022-11-24","publish_status":"0","recid":"27770","relation_version_is_last":true,"title":["Development of eosinophilic granulomatosis with polyangiitis during the clinical course of microscopic polyangiitis: A case report"],"weko_creator_id":"6","weko_shared_id":-1},"updated":"2023-05-15T19:22:14.358679+00:00"}